Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone Test Bank

Medical Surgical Nursing Clinical

Reasoning in Patient Care 6th Edition
LeMone Test Bank
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Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone Test Bank

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Chapter 3

Question 1
Type: MCSA

When planning holistic care for a patient admitted with heart failure, what should the nurse include?

1. spiritual needs

2. measuring intake and output

3. daily weights

4. ambulating with assistance

Correct Answer: 1

Rationale 1: Holistic health care is based on the concept of wellness. When planning holistic care for a patient,
the nurse needs to consider psychosocial, cultural, spiritual, and intellectual needs in addition to physical needs.

Rationale 2: Measuring intake and output meets the patient’s physical needs and would not address holistic
needs.

Rationale 3: Daily weights focus solely on the patient’s physical needs and would not address holistic needs.

Rationale 4: Ambulating with assistance focuses solely on the patient’s physical needs and would not address
holistic needs.

Global Rationale: Holistic health care is based on the concept of wellness. When planning holistic care for a
patient, the nurse needs to consider psychosocial, cultural, spiritual, and intellectual needs in addition to physical
needs. Measuring intake and output, daily weights, and ambulating with assistance focus solely on the patient’s
physical needs and would not address holistic needs.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding
of human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings
NLN Competencies: Relationship Centered Care; Knowledge; Factors that contribute to or threaten health
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1. Define health and discuss factors affecting the health of individuals, families, and
communities.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.

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MNL Learning Outcome: 6.8.4. Utilize the nursing process in care of client.
Page Number: 28

Question 2
Type: MCSA

A patient tells the nurse that he has been fortunate since he has never experienced any major illnesses and has
enjoyed good health without much effort. How should the nurse realize this patient is defining “good health?”

1. the absence of disease

2. effortless

3. fortunate

4. an integrated method of functioning

Correct Answer: 1

Rationale 1: The patient is defining “good health” as being the absence of disease since he states being fortunate
for not experiencing any major illnesses and not expending much effort to do so.

Rationale 2: The nurse has no way of knowing if the patient believes “good health” is effortless.

Rationale 3: The nurse has no way of knowing if the patient believes “good health” is effortless.

Rationale 4: An integrated method of functioning is the definition of wellness which the patient is not describing.

Global Rationale: The patient is defining “good health” as being the absence of disease since he states being
fortunate for not experiencing any major illnesses and not expending much effort to do so. The nurse has no way
of knowing if the patient believes “good health” is effortless. An integrated method of functioning is the definition
of wellness which the patient is not describing.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding
of human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings
NLN Competencies: Relationship Centered Care; Knowledge; Factors that contribute to or threaten health
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Define health and discuss factors affecting the health of individuals, families, and
communities.
MNL Learning Outcome:
Page Number: 28
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
Question 3
Type: MCSA

A patient tells the nurse that he often is concerned with his declining mobility status even though he continues to
experience no major health issues. When planning care according to the wellness framework, what should the
nurse include for this patient?

1. interventions to restore the patient’s mobility status

2. activities to promote the current level of functioning

3. suggestions to maintain the patient’s current mobility status

4. activities to help the patient cope with the decline in mobility status

Correct Answer: 1

Rationale 1: Providing care based on a framework of wellness facilitates active involvement by both the nurse
and the patient in promoting, maintaining, or restoring health. Because the patient is concerned with declining
mobility status, the nurse should include interventions to help restore this status for the patient.

Rationale 2: Activities to promote the current level of functioning would not support wellness care.

Rationale 3: Providing suggestions to maintain the patient’s current mobility status would not support wellness
care.

Rationale 4: Helping the patient cope with the decline in mobility status would not support wellness care.

Global Rationale: Providing care based on a framework of wellness facilitates active involvement by both the
nurse and the patient in promoting, maintaining, or restoring health. Because the patient is concerned with
declining mobility status, the nurse should include interventions to help restore this status for the patient.
Activities to promote the current level of functioning, providing suggestions to maintain the patient’s current
mobility status, and helping the patient cope with the decline in mobility status would also not support wellness
care.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding
of human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings
NLN Competencies: Relationship Centered Care; Knowledge; Factors that contribute to or threaten health
Nursing/Integrated Concepts: Nursing Process: Planning

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Copyright 2015 by Pearson Education, Inc.
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